There are many options for obstetric care out there. There are OB/GYN physicians, family practice providers, nurse midwife groups who work under the observation of a physician, independent nurse midwife groups, birthing center midwives, home birth midwives and certified professional midwives. The opportunities are endless and in many areas, we are fortunate enough to have the option to choose which type of provider we want.
What I think is most important in choosing a provider, is choosing one who best supports your priorities during the labor and delivery of your child. This means different things to different mamas. Some mamas want an epidural or c-section. Some strive for an all-natural birthing process. Some desire to push baby out on a hospital bed, while others desire to deliver their newborn in the comfort of their own home. There are benefits and risks to all of these scenarios and it is important as a pregnant mama to sit down, research, process and develop an idea of what an ideal birth looks like. Again, this is different for everyone.
As many of us know, there is no way of knowing how our laboring process will go. We can have every possible detail prepared for and something we didn’t think of may still come up. We may go in planning to take no medications and change our minds partway through the laboring process. The truth is, we have about zero control of what baby is going to decide to do. Still, it is important to find a provider who supports what your ideal birth looks like.
For me, I knew from the beginning that I wanted to work with a midwife group. I met with several local midwives delivering in the hospital, a birth center and the home birth setting. I discussed the options with my husband, he met some of the midwives and we decided that working with a midwife who delivered babies in the hospital was a comfortable choice for us. While I do not intend to use an epidural, I want the option to be available. For my husband, he wants to make sure that should anything go wrong, we have quick access to emergency care to keep both me and baby safe.
The midwife group we started with is a great group. They were all very lovely to work with and I didn’t feel that anything was necessarily wrong, but as I got further into my pregnancy and learned more about my options during labor, I started to question more things and my feelings toward this group of women changed. I became very anxious and nervous about the thought of induction occurring at 41 weeks and 3 days. According to all of the research I had done, first time mamas sometimes go until 42 weeks before baby is ready to be delivered. I have seen women be induced in the past and it does not appear to be a pleasant experience for them. PLUS, it increases the risk of needing an epidural and having a c-section which are also things I hope to avoid.
Unfortunately, this midwife group worked under a physician and were required to follow the clinical guidelines for induction. This did not settle well with me. It felt like my birth was being dictated by someone else instead of my body. Throughout the course of a birthing class my husband and I were taking, I was also becoming more empowered. I learned that I had both the right and the power to choose my provider. Someone I would be comfortable with. So I began researching midwives again.
Through connections I made with other mamas in the community, I reached out to a midwife group who were less well-known in the mainstream hospital community. They work at the local regional hospital, which unfortunately has gotten a bad reputation in the past for reasons I am not aware of. I was a little nervous to go down this road, but immediately felt more empowered and comfortable in their care. Their views aligned more with what I was looking for in my birth experience and I felt supported. Here’s why:
- These midwives had previously done home births, indicating to me that they know how to work with women desiring a natural birth AND that they are able to catch baby no matter what position I decide to push in. I would not be confined to a hospital bed.
- My appointments with them were much more thorough than anything I had experienced previously. They really seem to care about baby and me.
- They call to check on baby and me, which is something the other group did not do either.
- I have access to labor and delivery nurses 24/7 via telephone if I have any concerns about baby. I thought this was standard for all obstetric practices, but I have learned this is not the case.
- These midwives work independently of the OB group at this hospital, giving them the freedom to let mamas go to 42 weeks gestation if both mama and baby are healthy. Of course, they do frequent monitoring and determine whether this is safe or not. There is still the option for induction and c-section should the need arise.
Of course, these are points that I feel very strongly about and unfortunately, the first provider group I worked with did not support all my ideas fully. These may not be needs that you have, but I encourage all pregnant mamas to inform themselves, determine what it is you desire in a provider and a birth, and be empowered to ask for what you need.
YOU are the patient. YOU must advocate for what is best for YOUR BABY. Use your resources. Advocate for the care you desire and deserve.